Targeted Therapy What the Surgeon Needs to Know

Size: px
Start display at page:

Download "Targeted Therapy What the Surgeon Needs to Know"

Transcription

1 Targeted Therapy What the Surgeon Needs to Know AATS Focus in Thoracic Surgery 2014 David R. Jones, M.D. Professor & Chief, Thoracic Surgery Memorial Sloan Kettering Cancer Center

2 I have no disclosures

3 The Personalized Cancer Care Continuum Meric-Bernstam F et al. JCO 2013

4 Categories of Genomic Alterations and Technologies for Detection MacConaill LE, J Clin Oncol 2013

5 Evolution of Multiplexed Testing Platforms Now-Gen MSK LC-MAP 8 genes Point mutations only Next-Gen MSK IMPACT 409 genes Point mutations, deletions, insertions, amplifications Comparable time and cost

6 Actionable Targets in Lung Adenocarcinomas Unknown 75% Unknown 60% EGFR Kris M et al. IASLC 2012 Targeted Therapies Conference

7 LCMC: Frequency of Oncogenic Drivers 733 Specimens with All 10 Drivers Assayed Kris JAMA 2014

8

9 Survival with the five most frequent oncogenic drivers group=alk group=doub group=egfr(o) group=egfr(s) group=kras YEARS Altered Gene N Median Survival (95% CI) EGFR (sensitizing) years (2.7 to 5.4) EGFR (other) years (2.2 to 6.2) ALK years (3.0 to NA) KRAS years (1.9 to 3.6) Two Drivers years (1.6 to 4.6) p=0.001

10 Scientific Breakthrough of the Year

11 PD1 Pathway Checkpoint Inhibitors Bristol Myers Squib

12 Immunomodulators in NSCLC Nivolumab: a fully human IgG4 monoclonal antibody that acts as an immunomodulator by blocking ligand activation of the programmed cell death 1 (PD-1) receptor on activated T cells. Ipilimumab: (FDA) approved for the treatment of melanoma, is a monoclonal antibody that activates the immune system by targeting CTLA-4, a protein receptor that downregulates the immune system.

13 What is the role of surgery in the era of targeted therapy for NSCLC?

14 Role of Surgery in the Molecularly-Targeted Era Surgical specimens are more valuable than biopsy or cytology specimens in understanding tumor heterogeneity Surgery is a therapeutic modality in the era of targeted therapy Surgery plays a role in personalized therapy and discovery in the peri-operative period Personalization of surgical procedures based on lung cancer subtypes.

15 Surgical Specimens and Tumor Heterogeneity Cell number not the issue ( cells adequate for PCR) Specimen quality is the issue (snap-frozen to prevent degradation of RNA) Driver mutation heterogeneity in NSCLC poorly understood Results varied for EGFR (10-86%) Recent Japanese study suggests little variation Targeted therapy pressure on the tumor results in changes in driver mutations (new mutations, new drivers) Surgical specimens: better quality RNA, improved understanding of tumor heterogeneity post-therapy Yatabe et al. J Clin Oncol 2011 Mitsudomi T et al., Nat Rev Clin Oncol 2013

16 Classes of Tumor Heterogeneity in Lung Adenocarcinoma Mitsudomi T et al., Nat Rev Clin Oncol 2013

17 ALCHEMIST-Related Adjuvant Therapy Trials (Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials) A Stage IB- IIIA NSCLC Complete Surgical Resection Screen for EGFR mutation+ cancers Adjuvant Therapy (if indicated) R a n d o m i z e Erlotinib X 2 years Placebo E4517 Stage IB- IIIA NSCLC Complete Surgical Resection Screen for ALK+ cancers Adjuvant Therapy (if indicated) R a n d o m i z e Crizotinib X 2 years Placebo

18 LCMC 3.0: Core Neoadjuvant Care and Research Paradigm - Clinical Stage I-IIIA Lung Cancers - Operable -Resectable Current 5 Year Survival < 50% Primary Endpoint: Major Pathologic Response Clinical Goal: Double MPR Rate Neoadjuvant Therapy SURGERY Assess pathologic response Postoperative Therapy Recurrence Biopsy #1 NextGen Genotyping RNA Seq Biopsy #2 NextGen Genotyping RNA Seq Biopsy #3 NextGen Genotyping RNA Seq

19 Induction Targeted Therapy Followed by Surgery Journal of Thoracic Oncology

20 Surgery as a Therapeutic Modality in Oligometastatic Disease A local therapy (surgery vs. RT) is indicated in selected cases of localized metastatic disease Lung, adrenal, bone, lymph nodes, liver, brain, pleural implant Increased numbers of these cases for consideration Depends on the morbidity, invasiveness, and impact on quality of life of the surgical procedure Ultimately will also depend on the cost of the approach related to the outcome (i.e. value)

21 Surgery is a Therapeutic Modality in the Era of Targeted Therapy Surgery is therapeutic in localized tumor(s) with acquired resistance when it occurs (it occurs in all patients) Cytotoxic chemotherapy largely ineffective after TKIs Cancer stem cells resistance to cytotoxic chemotherapy Tumor genomic information following resection highly relevant for subsequent therapy if/when recurrence Identification of mutations associated with acquired resistance New driver mutations, new tumor histologies (large cell, small cell) Mitsudomi T et al., Nat Rev Clin Oncol 2013 xx

22 Role of Surgery in Managing Resistance in the Treatment of Lung Cancer Mitsudomi T et al., Nat Rev Clin Oncol 2013

23 Tumor Boards of the Future: What s Missing? Roychawdhury S et al., Sci Translat Med 2011

24

25 Surgery Personalization by Tumor Subtype Should all tumors receive the same procedure? Tumor size Specific histologic morphologies Nodal dissection/sampling GGO vs. semi-solid lesions Are there exceptions to the R0 oncologic principle of resection? Multiple GGO or subcentimeter lesions Could surgery be used as adjuvant therapy for earlystage lung cancer?

26 Surgery in the Era of Targeted Therapy Conclusions New day in oncologic surgery New challenges and new opportunities The era of molecular oncology is here to stay Role of surgery/surgeons depends on quality, outcomes, value New opportunities to collaborate with others in the diagnosis, treatment, follow-up of cancer patients

27 Approved Oncology Drugs with Anti-Tumor Activity in Specific Molecular Subsets Sleijfer et al. J Clin Oncol 2013

28 Exploratory integrative sequencing of tumors for personalized oncology Roychawdhury S et al., Sci Translat Med 2011

29 Genomic Alterations in Common Solid Tumor Malignancies Garraway LA, J Clin Oncol 2013

30 Impact of MSK Impact MSK Patients with Thoracic Cancers Scorecard - October 2014 Gene Targets in NCCN Guidelines 7 Targeted Drugs in NCCN Compendia 12 Gene Targets for Investigational Agents 17 Trials of Targeted Therapies for Specific Genes 30

ALCHEMIST (Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials)

ALCHEMIST (Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials) ALCHEMIST (Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials) 3 Integrated Trials Testing Targeted Therapy in Early Stage Lung Cancer Part of NCI s Precision Medicine Effort in

More information

Moving forward, where are we with Clinical Trials?

Moving forward, where are we with Clinical Trials? Moving forward, where are we with Clinical Trials? Dennis A. Wigle Division of Thoracic Surgery Mayo Clinic AATS/STS General Thoracic Surgery Symposium Sunday, April 27 th 2014 2012 MFMER slide-1 Where

More information

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 Adjuvant Therapy Non Small Cell Lung Cancer Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 No Disclosures Number of studies Studies Per Month 12 10 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3

More information

Genomic Medicine The Future of Cancer Care. Shayma Master Kazmi, M.D. Medical Oncology/Hematology Cancer Treatment Centers of America

Genomic Medicine The Future of Cancer Care. Shayma Master Kazmi, M.D. Medical Oncology/Hematology Cancer Treatment Centers of America Genomic Medicine The Future of Cancer Care Shayma Master Kazmi, M.D. Medical Oncology/Hematology Cancer Treatment Centers of America Personalized Medicine Personalized health care is a broad term for interventions

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Molecular Analysis for Targeted Therapy for Non-Small Cell Lung File Name: Origination: Last CAP Review: Next CAP Review: Last Review: molecular_analysis_for_targeted_therapy_for_non_small_cell_lung_cancer

More information

Understanding series. new. directions. 1-800-298-2436 LungCancerAlliance.org. A guide for the patient

Understanding series. new. directions. 1-800-298-2436 LungCancerAlliance.org. A guide for the patient Understanding series LUNG CANCER: new treatment directions 1-800-298-2436 LungCancerAlliance.org A guide for the patient TABLE OF CONTENTS What s New in lung cancer? Advancements...4 Changes in genes that

More information

Non Small Cell Lung Cancer: Scientific Discoveries and the Pursuit of Progress

Non Small Cell Lung Cancer: Scientific Discoveries and the Pursuit of Progress Non Small Cell Lung Cancer: Scientific Discoveries and the Pursuit of Progress Lung Cancer Accounts for 14% of All New Cancer Diagnoses in the United States 1 Lung cancer is the second most common malignancy

More information

Nuevas tecnologías basadas en biomarcadores para oncología

Nuevas tecnologías basadas en biomarcadores para oncología Nuevas tecnologías basadas en biomarcadores para oncología Simposio ASEBIO 14 de marzo 2013, PCB Jose Jimeno, MD, PhD Co-Founder / Vice Chairman Pangaea Biotech SL Barcelona, Spain PANGAEA BIOTECH BUSINESS

More information

REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM

REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM Valerie Van Damme, Isabelle Wauters, Johan Vansteenkiste Univ. Hospital Leuven and Leuven Lung Cancer Group Introduction Perspectives in Lung Cancer (PILC)

More information

The EGFR mutation and precision therapy for lung cancer

The EGFR mutation and precision therapy for lung cancer for lung cancer Outcomes in advanced lung cancer have seen meaningful improvement in the past decade thanks to new precision drug therapies. Because tumors usually develop resistance to the drugs, scientists

More information

Future Directions in Clinical Research. Karen Kelly, MD Associate Director for Clinical Research UC Davis Cancer Center

Future Directions in Clinical Research. Karen Kelly, MD Associate Director for Clinical Research UC Davis Cancer Center Future Directions in Clinical Research Karen Kelly, MD Associate Director for Clinical Research UC Davis Cancer Center Outline 1. Status of Cancer Treatment 2. Overview of Clinical Research at UCDCC 3.

More information

Prognostic and Predictive Factors in Oncology. Mustafa Benekli, M.D.

Prognostic and Predictive Factors in Oncology. Mustafa Benekli, M.D. Prognostic and Predictive Factors in Oncology Mustafa Benekli, M.D. NCI Definitions ESMO Course -Essentials of Medical Oncology -Istanbul 2 Prognostic factor: NCI Definition A situation or condition, or

More information

The Need for Accurate Lung Cancer Staging

The Need for Accurate Lung Cancer Staging The Need for Accurate Lung Cancer Staging Peter Baik, DO Thoracic Surgery Cancer Treatment Centers of America Oklahoma Osteopathic Association 115th Annual Convention Financial Disclosures: None 2 Objectives

More information

Breast and Lung Cancer Biomarker Research at ASCO: Changing Treatment Patterns

Breast and Lung Cancer Biomarker Research at ASCO: Changing Treatment Patterns July 2013 Edition Vol. 7, Issue 7 Breast and Lung Cancer Biomarker Research at ASCO: Changing Treatment Patterns By Julie Katz, MPH, MPhil Biomarkers played a prominent role in the research presented in

More information

Lung Cancer Treatment Guidelines

Lung Cancer Treatment Guidelines Updated June 2014 Derived and updated by consensus of members of the Providence Thoracic Oncology Program with the aid of evidence-based National Comprehensive Cancer Network (NCCN) national guidelines,

More information

CLINICAL POLICY Department: Medical Management Document Name: Opdivo Reference Number: CP.PHAR.121 Effective Date: 07/15

CLINICAL POLICY Department: Medical Management Document Name: Opdivo Reference Number: CP.PHAR.121 Effective Date: 07/15 Page: 1 of 6 IMPORTANT REMINDER This Clinical Policy has been developed by appropriately experienced and licensed health care professionals based on a thorough review and consideration of generally accepted

More information

Successes and Limitations of Targeted Cancer Therapy in Lung Cancer

Successes and Limitations of Targeted Cancer Therapy in Lung Cancer Successes and Limitations of Targeted Cancer Therapy in Lung Cancer Kenichi Suda a, b Tetsuya Mitsudomi a a Division of Thoracic Surgery, Department of Surgery, Kinki University Faculty of Medicine, Osaka-Sayama,

More information

Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate

Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate + Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma Claire Vines, 2016 Pharm.D. Candidate + Disclosure I have no conflicts of interest to disclose. + Objectives Summarize NCCN

More information

Management of stage III A-B of NSCLC. Hamed ALHusaini Medical Oncologist

Management of stage III A-B of NSCLC. Hamed ALHusaini Medical Oncologist Management of stage III A-B of NSCLC Hamed ALHusaini Medical Oncologist Global incidence, CA cancer J Clin 2011;61:69-90 Stage III NSCLC Includes heterogeneous group of patients with differences in the

More information

Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer

Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer Protein kinase C alpha expression and resistance to neo-adjuvant gemcitabine-containing chemotherapy in non-small cell lung cancer Dan Vogl Lay Abstract Early stage non-small cell lung cancer can be cured

More information

Pharmacogenomic markers in EGFR-targeted therapy of lung cancer

Pharmacogenomic markers in EGFR-targeted therapy of lung cancer Pharmacogenomic markers in EGFR-targeted therapy of lung cancer Rafal Dziadziuszko, MD, PhD University of Colorado Cancer Center, Aurora, CO, USA Medical University of Gdansk, Poland EMEA Workshop on Biomarkers,

More information

Harmesh Naik, MD. Hope Cancer Clinic HOW DO I MANAGE STAGE 4 NSCLC IN 2012: STATE OF THE ART

Harmesh Naik, MD. Hope Cancer Clinic HOW DO I MANAGE STAGE 4 NSCLC IN 2012: STATE OF THE ART Harmesh Naik, MD. Hope Cancer Clinic HOW DO I MANAGE STAGE 4 NSCLC IN 2012: STATE OF THE ART Goals Discuss treatment options for stage 4 lung cancer: New and old Discuss new developments in personalized

More information

Public-Private Partnerships in early phase clinical research: Spurring access to innovative therapeutics

Public-Private Partnerships in early phase clinical research: Spurring access to innovative therapeutics EPAAC WP8 Research Forum - 2 July, Sofitel Hotel Europe, Brussels Public-Private Partnerships in early phase clinical research: Spurring access to innovative therapeutics JY Blay, Past President EORTC

More information

Lung Cancer. Advances in Lung Cancer Treatment

Lung Cancer. Advances in Lung Cancer Treatment Lung Cancer Advances in Lung Cancer Treatment Treatment for lung cancer is changing rapidly. There are new therapies that target specific molecular changes that drive the growth and spread of the lung

More information

targeted therapy a guide for the patient

targeted therapy a guide for the patient targeted therapy FOR LUNG CANCER a guide for the patient TABLE OF CONTENTS lung cancer basics... 2-3 Gene changes... 4-5 Testing... 7-8 Targeted therapy... 9-11 Drugs Targeting EGFR... 12 Drugs Targeting

More information

Lung Cancer: More than meets the eye

Lung Cancer: More than meets the eye Lung Cancer Education Program November 23, 2013 Lung Cancer: More than meets the eye Shantanu Banerji MD, FRCPC Presenter Disclosure Faculty: Shantanu Banerji Relationships with commercial interests: Grants/Research

More information

Clinical development of AZD9291 in non-small cell lung cancer

Clinical development of AZD9291 in non-small cell lung cancer Clinical development of AZD9291 in non-small cell lung cancer Rachael Lawrance (AstraZeneca) PSI One Day Meeting: The Innovative, Challenging and Diversified World of Respiratory Disease 13 Nov 2015 Overview

More information

POLICY A. INDICATIONS

POLICY A. INDICATIONS Alimta (pemetrexed) Line(s) of Business: HMO; PPO; QUEST Integration Akamai Advantage Original Effective Date: 09/01/2007 Current Effective Date: 10/01/2015 POLICY A. INDICATIONS The indications below

More information

Immune Therapy for Pancreatic Cancer

Immune Therapy for Pancreatic Cancer Immune Therapy for Pancreatic Cancer December 16, 2014 If you experience technical difficulty during the presentation: Contact WebEx Technical Support directly at: US Toll Free: 1-866-229-3239 Toll Only:

More information

Your Immune System & Lung Cancer Treatment

Your Immune System & Lung Cancer Treatment Your Immune System & Lung Cancer Treatment Immunotherapy and Lung Cancer Immunotherapy is quickly developing as an important approach to treating many forms of cancer, including lung cancer. Immunotherapy

More information

CANCER PULMON: ESTADIOS INICIALES POSTMUNDIAL PULMON DENVER 2015. 8-10-2015.Manuel Cobo Dols S. Oncología Médica HU Málaga Regional y VV

CANCER PULMON: ESTADIOS INICIALES POSTMUNDIAL PULMON DENVER 2015. 8-10-2015.Manuel Cobo Dols S. Oncología Médica HU Málaga Regional y VV CANCER PULMON: ESTADIOS INICIALES POSTMUNDIAL PULMON DENVER 2015 8-10-2015.Manuel Cobo Dols S. Oncología Médica HU Málaga Regional y VV Meta-analisis LACE: adyuvancia vs no adyuvancia Pignon JP, et al.

More information

Targeted Therapies in Lung Cancer

Targeted Therapies in Lung Cancer Targeted Therapies in Lung Cancer I Edited by: Simona Carnio Thoracic Oncology Division - St Luigi Hospital Orbassano (TO) - Italy Silvia Novello Department of Oncology - University of Torino - Italy Why

More information

Pharmacogenomic Approaches. Luis Paz-Ares Hospital Universitario Virgen del Rocio Seville, Spain

Pharmacogenomic Approaches. Luis Paz-Ares Hospital Universitario Virgen del Rocio Seville, Spain Pharmacogenomic Approaches Luis Paz-Ares Hospital Universitario Virgen del Rocio Seville, Spain Pharmacogenetics & Pharmacogenomics Medicine tailored to the individual Genetic information, including the

More information

Cetuximab (Erbitux) MM.04.005 05/10/2005. HMO; PPO; QUEST Integration 01/01/2015 Section: Prescription Drugs Place(s) of Service: Office: Outpatient

Cetuximab (Erbitux) MM.04.005 05/10/2005. HMO; PPO; QUEST Integration 01/01/2015 Section: Prescription Drugs Place(s) of Service: Office: Outpatient Cetuximab (Erbitux) Policy Number: Original Effective Date: MM.04.005 05/10/2005 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 01/01/2015 Section: Prescription Drugs Place(s)

More information

LCFA/IASLC LORI MONROE SCHOLARSHIP IN TRANSLATIONAL LUNG CANCER RESEARCH

LCFA/IASLC LORI MONROE SCHOLARSHIP IN TRANSLATIONAL LUNG CANCER RESEARCH LCFA/IASLC LORI MONROE SCHOLARSHIP IN TRANSLATIONAL LUNG CANCER RESEARCH FUNDING OPPORTUNITY DESCRIPTION 2016 REQUEST FOR APPLICATION (RFA) Lung Cancer Foundation of America (LCFA) and the International

More information

PET/CT Imaging in Lung Cancer

PET/CT Imaging in Lung Cancer PET/CT Imaging in Lung Cancer Mylene T. Truong, MD Mylene T. Truong M.D. Objectives To discuss the role of PET/CT in the staging of lung cancer To review the recommendations from American Society of Clinical

More information

HER2 Status: What is the Difference Between Breast and Gastric Cancer?

HER2 Status: What is the Difference Between Breast and Gastric Cancer? Ask the Experts HER2 Status: What is the Difference Between Breast and Gastric Cancer? Bharat Jasani MBChB, PhD, FRCPath Marco Novelli MBChB, PhD, FRCPath Josef Rüschoff, MD Robert Y. Osamura, MD, FIAC

More information

Mesothelioma. Malignant Pleural Mesothelioma

Mesothelioma. Malignant Pleural Mesothelioma Mesothelioma William G. Richards, PhD Brigham and Women s Hospital Malignant Pleural Mesothelioma 2,000-3,000 cases per year (USA) Increasing incidence Asbestos (50-80%, decreasing) 30-40 year latency

More information

targeted cancer therapy

targeted cancer therapy LUNG CANCER TREATMENTS What you need to know about... targeted cancer therapy foreword About LUNGevity LUNGevity is the largest national lung cancer-focused nonprofit, changing outcomes for people with

More information

NEW CLINICAL RESEARCH OPTIONS IN PANCREATIC CANCER IMMUNOTHERAPY. Alan Melcher Professor of Clinical Oncology and Biotherapy Leeds

NEW CLINICAL RESEARCH OPTIONS IN PANCREATIC CANCER IMMUNOTHERAPY. Alan Melcher Professor of Clinical Oncology and Biotherapy Leeds NEW CLINICAL RESEARCH OPTIONS IN PANCREATIC CANCER IMMUNOTHERAPY Alan Melcher Professor of Clinical Oncology and Biotherapy Leeds CANCER IMMUNOTHERAPY - Breakthrough of the Year in Science magazine 2013.

More information

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011 Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer Shannon Acker April 4, 2011 Rectal Cancer 40,870 new cases in the US in 2009 49,920 deaths from colorectal cancer Second leading cause

More information

Ovarian Cancer and Modern Immunotherapy: Regulatory Strategies for Drug Development

Ovarian Cancer and Modern Immunotherapy: Regulatory Strategies for Drug Development Ovarian Cancer and Modern Immunotherapy: Regulatory Strategies for Drug Development Sanjeeve Bala, MD, MPH Ovarian Cancer Endpoints Workshop FDA White Oak September 3, 2015 Overview Immune agents from

More information

Breakthrough Lung Cancer Treatment Approved Webcast September 9, 2011 Renato Martins, M.D., M.P.H. Introduction

Breakthrough Lung Cancer Treatment Approved Webcast September 9, 2011 Renato Martins, M.D., M.P.H. Introduction Breakthrough Lung Cancer Treatment Approved Webcast September 9, 2011 Renato Martins, M.D., M.P.H. Please remember the opinions expressed on Patient Power are not necessarily the views of Seattle Cancer

More information

Clinical Use of Molecular Diagnos@cs in the Treatment of Lung Cancer

Clinical Use of Molecular Diagnos@cs in the Treatment of Lung Cancer Clinical Use of Molecular Diagnos@cs in the Treatment of Lung Cancer Tianhong Tina Li, MD, PhD (thli@ucdavis.edu) Associate Professor of Clinical Medicine, School of Medicine Disclosures Grants/Research

More information

RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What?

RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What? RESEARCH EDUCATE ADVOCATE Just Diagnosed with Melanoma Now What? INTRODUCTION If you are reading this, you have undergone a biopsy (either of a skin lesion or a lymph node) or have had other tests in which

More information

2011 ATS International Conference May 13-18, 2011 Denver, Colorado CME POST-TEST QUESTIONAIRE

2011 ATS International Conference May 13-18, 2011 Denver, Colorado CME POST-TEST QUESTIONAIRE 2011 ATS International Conference May 13-18, 2011 Denver, Colorado CME POST-TEST QUESTIONAIRE Please fill your post-test answers in on this page and fax it back to the ATS Education Unit, ATTN: Elizabeth

More information

Inspira (Vineland/Woobury) Open Clinical Trials as of December 16, 2015

Inspira (Vineland/Woobury) Open Clinical Trials as of December 16, 2015 Inspira (Vineland/Woobury) Open Clinical Trials as of December 16, 2015 Advanced Refractory Solid Tumors or Lymphomas ECOG-ACRIN EAY131 (NCI CIRB) Targeted Therapy Directed by Genetic Testing in Treating

More information

Effects of Herceptin on circulating tumor cells in HER2 positive early breast cancer

Effects of Herceptin on circulating tumor cells in HER2 positive early breast cancer Effects of Herceptin on circulating tumor cells in HER2 positive early breast cancer J.-L. Zhang, Q. Yao, J.-H. Chen,Y. Wang, H. Wang, Q. Fan, R. Ling, J. Yi and L. Wang Xijing Hospital Vascular Endocrine

More information

Malignant Mesothelioma: an Update

Malignant Mesothelioma: an Update Malignant Mesothelioma: an Update Nico van Zandwijk Asbestos Diseases Research Institute Bernie Banton Centre University of Sydney Australia Physicians Week RACP 19-5-2009 Health Risks of Asbestos Fibers

More information

Genomic Clinical Trials: NCI Initiatives

Genomic Clinical Trials: NCI Initiatives Genomic Clinical Trials: NCI Initiatives James H. Doroshow, M.D. Deputy Director for Clinical and Translational Research National Cancer Institute National Cancer Advisory Board Washington, DC December

More information

Pancreatic Cancer: FDA Approved Treatments and Clinical Trials

Pancreatic Cancer: FDA Approved Treatments and Clinical Trials Pancreatic Cancer: FDA Approved Treatments and Clinical Trials Vincent J Picozzi MD MMM Virginia Mason Medical Center Seattle WA 1 Pancreatic cancer is the hardest cancer of all to treat 2 Pancreatic cancer:

More information

ROLE OF RADIATION THERAPY FOR RESECTABLE LUNG CANCER

ROLE OF RADIATION THERAPY FOR RESECTABLE LUNG CANCER AFA 08958 From Bench to Bedside From KK DT1 10/27/2015 12:04 PM 01 ROLE OF RADIATION THERAPY FOR RESECTABLE LUNG CANCER Hak Choy, MD University of Texas Southwestern Medical Center Dallas, Texas, USA Orchestrating

More information

Recruiting now. Could you help by joining this study?

Recruiting now. Could you help by joining this study? Non-Small Cell Lung Cancer Recruiting now AstraZeneca is looking for men and women with locally advanced or metastatic non-small cell lung cancer (NSCLC) to join ATLANTIC, a clinical study to help investigate

More information

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Maintenance therapy in in Metastatic NSCLC Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Definition of Maintenance therapy The U.S. National Cancer Institute s

More information

Lung Cancer and Mesothelioma

Lung Cancer and Mesothelioma Lung Cancer and Mesothelioma Robert Kratzke, M.D. John C. Skoglund Professor of Lung Cancer Research Section of Heme/Onc/Transplant Department of Medicine University of Minnesota Medical School Malignant

More information

A Practical Guide to Advances in Staging and Treatment of NSCLC

A Practical Guide to Advances in Staging and Treatment of NSCLC A Practical Guide to Advances in Staging and Treatment of NSCLC Robert J. Korst, M.D. Director, Thoracic Surgery Medical Director, The Blumenthal Cancer Center The Valley Hospital Objectives Revised staging

More information

SAKK Lung Cancer Group. Current activities and future projects

SAKK Lung Cancer Group. Current activities and future projects SAKK Lung Cancer Group Current activities and future projects SAKK Lung Cancer Group Open group of physicians interested in lung cancer Mostly Medical Oncologists, but also Thoracic Surgeons Radiation

More information

Médecine de précision médecine personnalisée en Oncologie. Fabien Calvo, Directeur Recherche et Innovation, INCa, Directeur ITMO Cancer, AVIESAN

Médecine de précision médecine personnalisée en Oncologie. Fabien Calvo, Directeur Recherche et Innovation, INCa, Directeur ITMO Cancer, AVIESAN Médecine de précision médecine personnalisée en Oncologie Fabien Calvo, Directeur Recherche et Innovation, INCa, Directeur ITMO Cancer, AVIESAN Successful targeted drug development Rapid identification

More information

National Clinical Trials Network Groups Update Fall 2014

National Clinical Trials Network Groups Update Fall 2014 National Clinical Trials Network Groups Update Fall 2014 Walter J Curran, Jr, MD An NRG Oncology Group Chair Executive Director Winship Cancer Institute of Emory University Atlanta, GA NCTN Groups Update

More information

Brigham and Women s Hospital, Boston, MA, USA; 2 Verastem, Inc., Boston, MA, USA

Brigham and Women s Hospital, Boston, MA, USA; 2 Verastem, Inc., Boston, MA, USA Determination of Biomarker Response in a Phase II Window of Opportunity Study of Defactinib (VS 6063), a Focal Adhesion Kinase (FAK) Inhibitor, in Patients with Resectable Malignant Pleural Mesothelioma

More information

Non-Small Cell Lung Cancer

Non-Small Cell Lung Cancer Non-Small Cell Lung Cancer in East tasia Chia-Chi (Josh) Lin, MD, PhD 林 家 齊 Director of Phase I Center, e Department of Oncology, National Taiwan University Hospital Clinical Associate Professor, Department

More information

Outline. Predictive Assays in Radiation Therapy Immunotherapy in Cancer Treatment. Introduction. Current clinical practice

Outline. Predictive Assays in Radiation Therapy Immunotherapy in Cancer Treatment. Introduction. Current clinical practice Predictive Assays in Radiation Therapy Immunotherapy in Cancer Treatment Radiation Biology Outline Introduction: Predictive assays in radiation therapy Examples for specific tumors Immunotherapy Summary

More information

PET/CT in Lung Cancer

PET/CT in Lung Cancer PET/CT in Lung Cancer Rodolfo Núñez Miller, M.D. Nuclear Medicine and Diagnostic Imaging Section Division of Human Health International Atomic Energy Agency Vienna, Austria GLOBOCAN 2012 #1 #3 FDG-PET/CT

More information

Update on Clinical Trials and Foundation Funded Grants

Update on Clinical Trials and Foundation Funded Grants Update on Clinical Trials and Foundation Funded Grants Mary Hesdorffer, MS, APRN-BC Medical Liaison Meso Foundation www.curemeso.org Delivering the Diagnosis Delivering the Diagnosis Day 1 Taking control

More information

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D.

Lung Cancer: Practical Application of Imaging In Determining Resectability. Jeremy J. Erasmus, M. D. Lung Cancer: Practical Application of Imaging In Determining Resectability Jeremy J. Erasmus, M. D. 62 year old man with a superior sulcus tumor. Which of the following precludes surgical resection in

More information

Guideline Development The American Society of Clinical Oncology

Guideline Development The American Society of Clinical Oncology Assessing Genomic Sequencing Information for Health Care Decision Making Decision Making Once Evidence is Assessed/Graded Evaluated Guideline Development The American Society of Clinical Oncology Gary

More information

AKT1 APC BRAF CTNNB1 KIT EGFR IDH1 MAP2K1 KRAS NOTCH1 NRAS PIK3CA TP53 PTEN. Rapid Tumor Genotyping in Solid Tumors

AKT1 APC BRAF CTNNB1 KIT EGFR IDH1 MAP2K1 KRAS NOTCH1 NRAS PIK3CA TP53 PTEN. Rapid Tumor Genotyping in Solid Tumors AKT1 AC BRAF CTNNB1 KIT IDH1 MA2K1 NOTCH1 NRAS IK3CA TEN T53 Rapid Tumor Genotyping in Solid Tumors Tumor Genotyping ersonalized Medicine Requires ersonalized Diagnostics Biological discoveries utilizing

More information

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine and systemic chemotherapy in malignant pleural mesothelioma. A 10-year experience. L Lang-Lazdunski, A Bille, S Marshall, R Lal,

More information

Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD

Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD Epidemiology, Staging and Treatment of Lung Cancer Mark A. Socinski, MD Associate Professor of Medicine Multidisciplinary Thoracic Oncology Program Lineberger Comprehensive Cancer Center University of

More information

Innovation: Present Meets Future

Innovation: Present Meets Future Innovation: Present Meets Future SOCIAL INNOVATION Leading Innovation in the Cooperative Group Setting Craig Nichols, M.D. BEST OF SWOG Barlogie-Salmon Myeloma Committee Robert Z. Orlowski, M.D., Ph.D.

More information

Summary of Discussion on Non-clinical Pharmacology Studies on Anticancer Drugs

Summary of Discussion on Non-clinical Pharmacology Studies on Anticancer Drugs Provisional Translation (as of January 27, 2014)* November 15, 2013 Pharmaceuticals and Bio-products Subcommittees, Science Board Summary of Discussion on Non-clinical Pharmacology Studies on Anticancer

More information

CancerStemCell Markers in Lung Cancers: Proofsof. Reservations. Lourdes Cortes-Dericks, PhD University of Hamburg Hamburg, Germany

CancerStemCell Markers in Lung Cancers: Proofsof. Reservations. Lourdes Cortes-Dericks, PhD University of Hamburg Hamburg, Germany CancerStemCell Markers in Lung Cancers: Proofsof ConceptsandSome Reservations Lourdes Cortes-Dericks, PhD University of Hamburg Hamburg, Germany Lung cancer: highest death rate and poorest patient survival

More information

The Past, Present & Future of Cancer Immunotherapy:

The Past, Present & Future of Cancer Immunotherapy: Article The Past, Present & Future of Cancer Immunotherapy: An Overview Recently BioWorld called cancer immunotherapy white hot based on unprecedented investments in private companies, partnerships between

More information

Report series: General cancer information

Report series: General cancer information Fighting cancer with information Report series: General cancer information Eastern Cancer Registration and Information Centre ECRIC report series: General cancer information Cancer is a general term for

More information

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Medical Expert: Breast Rotation Specific Competencies/Objectives 1.0 Medical History

More information

Researching Cancer Medicines: Setbacks and Stepping Stones

Researching Cancer Medicines: Setbacks and Stepping Stones Researching Cancer Medicines: Setbacks and Stepping Stones Researching Cancer Medicines: Setbacks and Stepping Stones 2 Executive Summary 3 Introduction 4 The Human Burden 5 The Economic Burden 6 Understanding

More information

The New International Staging System Lung Cancer

The New International Staging System Lung Cancer The New International Staging System Lung Cancer Valerie W. Rusch, MD Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center Chair, Lung and Esophagus Task Force, American Joint Commission on Cancer

More information

FAK INHIBITOR DEFACTINIB (VS-6063) TARGETS MESOTHELIOMA CANCER STEM CELLS. Jonathan Pachter, Ph.D.

FAK INHIBITOR DEFACTINIB (VS-6063) TARGETS MESOTHELIOMA CANCER STEM CELLS. Jonathan Pachter, Ph.D. FAK INHIBITOR DEFACTINIB (VS-6063) TARGETS MESOTHELIOMA CANCER STEM CELLS Rationale for maintenance therapy after conventional therapy Jonathan Pachter, Ph.D. Vice President of Research, Verastem, Inc.

More information

Predictive Biomarkers for PD1 Pathway Inhibitor Immunotherapy

Predictive Biomarkers for PD1 Pathway Inhibitor Immunotherapy Predictive Biomarkers for PD1 Pathway Inhibitor Immunotherapy Michael B. Atkins, M.D. Deputy Director Georgetown-Lombardi Comprehensive Cancer Center Michael Atkins, MD Consulting Fees (e.g., advisory

More information

What is New in Oncology. Michael J Messino, MD Cancer Care of WNC An affiliate of Mission hospitals

What is New in Oncology. Michael J Messino, MD Cancer Care of WNC An affiliate of Mission hospitals What is New in Oncology Michael J Messino, MD Cancer Care of WNC An affiliate of Mission hospitals Personalized Medicine Personalized Genomics Genomic Medicine Precision Medicine Definition Application

More information

Immunotherapy Concept Turned Reality

Immunotherapy Concept Turned Reality Authored by: Jennifer Dolan Fox, PhD VirtualScopics Inc. jennifer_fox@virtualscopics.com +1 585 249 6231 Immunotherapy Concept Turned Reality Introduction While using the body s own immune system as a

More information

Metastatic Melanoma What You Need to Know

Metastatic Melanoma What You Need to Know ESSENTIALS Metastatic Melanoma Metastatic Melanoma What You Need to Know If you have metastatic melanoma, you may feel as though your life has been turned upside down. It s a serious disease, but patients

More information

Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines

Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines Non-Small Cell Lung Cancer Treatment Comparison to NCCN Guidelines April 2008 (presented at 6/12/08 cancer committee meeting) By Shelly Smits, RHIT, CCS, CTR Conclusions by Dr. Ian Thompson, MD Dr. James

More information

COMMISSIONING. for ULTRA-RADICAL SURGERY ADVANCED OVARIAN CANCER

COMMISSIONING. for ULTRA-RADICAL SURGERY ADVANCED OVARIAN CANCER COMMISSIONING for ULTRA-RADICAL SURGERY in ADVANCED OVARIAN CANCER WHY THIS MUST HAPPEN PERSPECTIVE COMMISSIONING FOR WHO, FOR WHAT? Biological Basis Surgical Basis International and national standards

More information

Update in Hematology Oncology Targeted Therapies. Mark Holguin

Update in Hematology Oncology Targeted Therapies. Mark Holguin Update in Hematology Oncology Targeted Therapies Mark Holguin 25 years ago Why I chose oncology People How to help people with possibly the most difficult thing they may have to deal with Science Turning

More information

Multidisciplinary discussion of: Early staged NSCLC

Multidisciplinary discussion of: Early staged NSCLC Multidisciplinary discussion of: Early staged NSCLC 2 different classes of patients Stage IIIA pt2pn2 Stage IIB pt3pn0 2 different classes of patients 50% 40% 30% 20% 10% 3y survival 50% 40% 30% 20% 10%

More information

Indications for Surgical Resection of Primary Lung Neoplasms Controversies, Problems and Techniques

Indications for Surgical Resection of Primary Lung Neoplasms Controversies, Problems and Techniques Indications for Surgical Resection of Primary Lung Neoplasms Controversies, Problems and Techniques Joshua Sonett, MD Weiskopf Professor of Surgical Oncology Chief Section of Thoracic Surgery Columbia

More information

New Trends & Current Research in the Treatment of Lung Cancer, Pt. II

New Trends & Current Research in the Treatment of Lung Cancer, Pt. II New Trends & Current esearch in the Treatment of Lung Cancer, Pt. II Howard (Jack) West, MD President & CEO, GACE Medical Director, Thoracic Oncology Program Swedish Cancer Institute Seattle, WA Cancer

More information

Monoclonal Antibodies in Cancer. Ralph Schwall, PhD Associate Director, Translational Oncology Genentech, Inc.

Monoclonal Antibodies in Cancer. Ralph Schwall, PhD Associate Director, Translational Oncology Genentech, Inc. Monoclonal Antibodies in Cancer Ralph Schwall, PhD Associate Director, Translational Oncology Genentech, Inc. Disclaimer I had nothing to do with Herceptin Using lessons learned in new antibody projects

More information

Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center

Principal Investigator: Valerie W. Rusch, MD, FACS, Chief, Thoracic Surgery Memorial Sloan-Kettering Cancer Center Protocol 1101-1088 Phase I study of intra-pleural administration of GL-ONC1 in patients with malignant pleural effusion: primary, metastases and mesothelioma Principal Investigator: Valerie W. Rusch, MD,

More information

NCCN Non-Small Cell Lung Cancer V.1.2011 Update Meeting 07/09/10

NCCN Non-Small Cell Lung Cancer V.1.2011 Update Meeting 07/09/10 Guideline Page and Request NSCL-3 Stage IA, margins positive delete the recommendation for chemoradiation. Stage IB, IIA, margins positive delete the recommendation for chemoradiation + Stage IIA, Stage

More information

Lung Cancer: Diagnosis, Staging and Treatment

Lung Cancer: Diagnosis, Staging and Treatment PATIENT EDUCATION patienteducation.osumc.edu Lung Cancer: Diagnosis, Staging and Treatment Cancer starts in our cells. Cells are the building blocks of our tissues. Tissues make up the organs of the body.

More information

Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology

Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate Professor Radiation Oncology Disclosure Information I have no financial relationships to disclose relevant to the conten of this presentation.

More information

oracic Oncology Advances

oracic Oncology Advances Winter 2011 oracic Oncology Advances Page 2 Page 4 Page 6 Page 7 Innovative Clinical Trials and Research Expand Targeted Medical Therapies and Personalized Approaches to Lung Cancer Care Medical oncologists

More information

An Introduction To Immunotherapy And The Promise Of Tissue Phenomics

An Introduction To Immunotherapy And The Promise Of Tissue Phenomics An Introduction To Immunotherapy And The Promise Of Tissue Phenomics INSIDE: n The Potential of Immunotherapy n Towards an Understanding of Immunotherapy n Current Approaches to Immunotherapy n The Immunotherapy

More information

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY Original Issue Date (Created): 9/1/2011 Most Recent Review Date (Revised): 1/27/2015 Effective Date: 11/2/2015 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS

More information

Foundational Issues Related to Immunotherapy and Melanoma

Foundational Issues Related to Immunotherapy and Melanoma Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including

More information

Come è cambiata la storia naturale della malattia

Come è cambiata la storia naturale della malattia Malattia Metastatica del Carcinoma del Grosso Intestino Tecniche e terapie Innovative Come è cambiata la storia naturale della malattia Antonio Frassoldati Oncologia Clinica - Ferrara 29 ottobre 2011 Colorectal

More information

Chirurgie des métastases cérébrales. Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals

Chirurgie des métastases cérébrales. Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals Chirurgie des métastases cérébrales Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals The Westmead patient population THE INCONVENIENT TRUTHS Cerebral metastases occur in 10 16 % of

More information

Description of Procedure or Service. assays_of_genetic_expression_to_determine_prognosis_of_breast_cancer 11/2004 3/2015 3/2016 3/2015

Description of Procedure or Service. assays_of_genetic_expression_to_determine_prognosis_of_breast_cancer 11/2004 3/2015 3/2016 3/2015 Corporate Medical Policy Assays of Genetic Expression to Determine Prognosis of Breast File Name: Origination: Last CAP Review: Next CAP Review: Last Review: assays_of_genetic_expression_to_determine_prognosis_of_breast_cancer

More information